De novo formation of a carotid web: case report.

Vercelli, Giovanni G; Campeau, Norbert G; Macedo, Thanila A; Dawson, Elliot T; Lanzino, Giuseppe · J Neurosurg · 2019

case_report · Level V

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Abstract

A carotid web is a shelf-like intraluminal filling defect typically arising from the posterolateral wall of the proximal internal carotid artery. It is recognized as a possible cause of ischemic stroke in young adults. However, its etiopathogenesis is controversial and remains to be fully elucidated. The authors report de novo formation of a carotid web from an intimal dissection documented on serial imaging studies. The findings in this case suggest that a focal intimal dissection could be the underlying cause of a carotid web. Lower shear stress at the posterolateral wall of the proximal internal carotid artery is hypothesized to be a predisposing factor and explains the predilection of a carotid web for this specific location.